Provider Demographics
NPI:1194808121
Name:AIKAWA, KEIKO (MD)
Entity type:Individual
Prefix:
First Name:KEIKO
Middle Name:
Last Name:AIKAWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 LOMBARDY LN
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-1110
Mailing Address - Country:US
Mailing Address - Phone:206-363-1004
Mailing Address - Fax:
Practice Address - Street 1:3443 VILLA LN
Practice Address - Street 2:STE 2
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6417
Practice Address - Country:US
Practice Address - Phone:707-253-8282
Practice Address - Fax:707-253-7023
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00C54986207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH17730Medicare UPIN